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ISSN: 1981-8963 DOI: 10.5205/reuol.3934-31164-1-SM.

0703esp201325

Carvalho JA de, Gurgel PKF, Lima KYN de et al. Analysis of youtube videos on…

ARTICLE INFORMATIONAL
ANALYSIS OF YOUTUBE VIDEOS ON BREASTFEEDING: RELEVANCE AND
BENEFIT
ANÁLISE DE VÍDEOS DO YOUTUBE SOBRE ALEITAMENTO MATERNO: IMPORTÂNCIA E
BENEFÍCIO
ANÁLISIS DE VIDEOS YOUTUBE DE LACTANCIA MATERNA: IMPORTANCIA Y BENEFICIOS
Jaidnara Alves de Carvalho1, Polyanna Keitte Fernandes Gurgel2, Kálya Yasmine Nunes de Lima3, Cilene Nunes
Dantas4, Cláudia Cristiane Filgueira Martins5
ABSTRACT
Objective: to analyze the videos on breastfeeding, existing on the video site YouTube, trying to identify the
influence that they could have in the mother's decision to breastfeed. Methodology: we have used a sample
of 405 videos, in a research conducted with the use of the controlled descriptor “breastfeeding”. The videos
were analyzed with the aid of a tool, by observing, mainly, the existence of information about the importance
of the breastfeeding act and its benefits. Results: the videos have demonstrated a positive influence and
make mention to the most important factors related to breastfeeding: six months of exclusive breastfeeding,
nutrition and protection for the newborn, and bond formation. Conclusion: by considering the importance of
the internet in disseminating information and need for continuity in the implementation of actions to
encourage breastfeeding, the study brings about a draft of the profile of videos on the issue found on the
YouTube, by characterizing them as a reliable source of research. Descriptors: Breastfeeding; Movies and
Educational Videos; YouTube.
RESUMO
Objetivo: analisar os vídeos sobre aleitamento materno, existentes no site de vídeos YouTube, buscando
identificar a influência que os mesmos poderiam ter na decisão das mães de amamentar. Metodologia: foi
utilizada a amostra de 405 vídeos, em pesquisa realizada com o uso do descritor controlado “aleitamento
materno”. Os vídeos foram analisados com o auxílio de instrumento, observando-se, principalmente, a
existência de informações acerca da importância do ato de amamentar e seus benefícios. Resultados: os
vídeos apresentam influência positiva e fazem referência aos fatores mais importantes relativos ao
aleitamento: seis meses de aleitamento materno exclusivo; nutrição e proteção para o bebê, e formação de
vínculo. Conclusão: considerando a importância da internet na divulgação da informação e necessidade de
continuidade na realização de ações de incentivo ao aleitamento materno, o estudo traz um esboço do perfil
dos vídeos sobre o tema encontrados no YouTube, caracterizando-os como uma fonte confiável de pesquisa.
Descritores: Aleitamento Materno; Filmes e Vídeos Educativos; YouTube.
RESUMEN
Objetivo: Analizar los vídeos sobre la lactancia materna, existiendo sitio de videos YouTube, tratando de
identificar la influencia que podría tener la decisión de la madre de amamantar. Metodología: La muestra
utilizada fue de 405 videos en una encuesta llevada a cabo con el uso de descriptor controlada "lactancia
materna". Los videos fueron analizados con la ayuda de un instrumento, observando principalmente a la
existencia de información sobre la importancia de la lactancia materna y sus beneficios. Resultados: Los
vídeos tienen una influencia positiva y hacer referencia a los factores más importantes relacionados con la
lactancia: seis meses de lactancia materna exclusiva, la nutrición y protección para el bebé, y la formación
del enlace. Conclusión: Teniendo en cuenta la importancia de Internet en la difusión de información y la
necesidad de continuidad en la implementación de acciones para fomentar la lactancia materna, el estudio
ofrece un resumen del perfil de vídeos sobre el tema se encuentra en YouTube, caracterizándolos como una
fuente confiable de investigación. Descriptores: Lactancia Materna; Películas Y Vídeos Educativos; YouTube.
1
Nurse, Graduated in Nursing from the Universidade Federal do Rio Grande do Norte/UFRN. Natal (RN). Brazil. E-mail:
flordomarrocos@yahoo.com.br; 2Undergraduated Student in Nursing from the Universidade Federal do Rio Grande do Norte /UFRN. Natal
(RN). Brazil. E-mail: gurgelpkf@gmail.com; 2Undergraduated Student in Nursing from the Universidade Federal do Rio Grande do Norte
/UFRN. Natal (RN). Brazil. E-mail: Yasmine.lima@hotmail.com; 3Nurse, Master in Nursing, Professor at the Undergraduate Nursing Course
from FACEX. Natal (RN). Brazil. E-mail: cilenenunesdantas@bol.com.br; 4Nurse, Master in Nursing, Natal (RN). Brazil. E-mail:
claudiacrisfm@yahoo.com.br; 5Nurse, PHD in Child and Youth Health, Professor at the Nursing Department from Universidade Federal do
Rio Grande do Norte/UFRN. Natal (RN), Brazil. Email: francistourinho@gmail.com.

English/Portuguese
J Nurs UFPE on line., Recife, 7(spe):1016-22, Mar., 2013 1016
ISSN: 1981-8963 DOI: 10.5205/reuol.3934-31164-1-SM.0703esp201325

Carvalho JA de, Gurgel PKF, Lima KYN de et al. Analysis of youtube videos on…

such a tool a more attractive means of


INTRODUCTION
information.
The Internet is a huge information system Misinformation can be decisive in the
integrated by computer networks, providing a maternal choice to breastfeed or not. Before
range of information resources and this context and the great ease of access to
information services for everyone that are information on the Internet, there was the
linked to it .1 concern about the quality of the videos posted
In the information's society, communication on YouTube about breastfeeding.
and information tend to permeate the This research aimed to analyze the
activities and decision-making processes in existence of videos concerning the
the different spheres of society, including the breastfeeding, regarding the pros and cons of
political superstructure, federal, state and breastfeeding, and verify if the same, due to
local governments, culture, arts, science, the lack of prior observation of the quality of
technology, education in its all instances, their content, are positively or negatively
health, industry, finance, trade, agriculture, influencing those who watch them and, from
environmental protection, community the results, to provide support for the
associations, professional societies, trade development of strategies to encourage
unions, popular manifestations, minorities, breastfeeding.
religions, sports, leisure, hobbies, etc. The
society starts to progressively operate in a METHODOLOGY
network.2 The research was exploratory and with
There are many tools that have emerged in quantitative nature, performed on the video-
recent years, which allow internet users to sharing site 'YouTube', whose virtual address
communicate in different ways. It is not is: <www.youtube.com>. Despite the
necessary to have a great technical existence of other video-sharing sites, the
knowledge, citizens have at their disposal a choice of YouTube took place because this is,
range of possibilities that allows them to currently, the most widespread among
participate in public space, sharing ideas or internet users.
merely entertaining themselves. Among these The research was conducted through
possibilities, there are blogs and vlogs, which visitations to the site, which took place
operate as places of active expression and without defined location, since there is not
participation of individuals with the most access restriction to this media, if it is
varied beliefs and ideologies. The ease and accessed from different locations, as with
the almost zero cost are important features some search portals. Moreover, there was the
for the success of such tools.3 need to limit the publication date of the
The growing success of YouTube, elected researched videos, since the renewal of the
by Time magazine “the best invention of number of videos on the site is constant.
2006” is an example. Within a year, YouTube Otherwise, it would not be possible to form a
has achieved a huge popularity. Television population and, consequently, a closed
programs, interviews, criticisms, reports, sample. The established upload date limit was
political speeches, home-made videos, June 30th, 2011.
curiosities, everything can be seen and The approval in an ethics committee was
shared, anytime and anywhere.3 not needed, since the search is not directly
Any individual, for any purpose, can use involved with human beings.
sites like YouTube to gain access to more Initially, we performed a search on the
diversified information. Likewise, making YouTube site with the help of the MesH term
censorship becomes increasingly difficult, "breastfeeding", from which we have obtained
since such information can start from multiple a sample of 405 videos. Due to the use of only
sources. 4 You should be careful about the one descriptor and aiming at a representative
veracity of what you read, see or hear on the sample, we have considered the 405 videos in
internet, because, in most cases, there is not their entirety for composing the sample.
a review of content that precedes the sharing. During the analysis, we applied some criteria
In search of information on breastfeeding, that determined the exclusion or inclusion of
many mothers may make use of YouTube videos. We observed whether the videos made
videos, in order to learn about how to do it direct reference to breastfeeding, by using as
when the time comes and get clarified about bases the title and description of each video,
myths and legends that exist with regard to and what was its language. In cases of
the breast milk and breastfeeding. In videos, absence of the said criteria or videos in
they have the opportunity to hear the theory foreign language, we opted for the exclusion.
and also observe the practice, which makes
English/Portuguese
J Nurs UFPE on line., Recife, 7(spe):1016-22, Mar., 2013 1017
ISSN: 1981-8963 DOI: 10.5205/reuol.3934-31164-1-SM.0703esp201325

Carvalho JA de, Gurgel PKF, Lima KYN de et al. Análise de Vídeos do YOUTUBE sobre…

During analysis, other exclusion criteria The data were worked into the form of
were applied: regarding the content of the tables according to the aforementioned
videos and the level of access of the site’s organization.
user.
RESULTS
For checking the quality of the videos, we
have designed a research tool with closed Of the 405 sample videos, 230 were
questions directed to the importance and discarded after application of the exclusion
benefits of breastfeeding. The questions have criteria, remaining 175 videos for the tool
covered: bond between mother and son; application, which represents less than 50% of
breast milk as natural vaccine and protection total.
against infections, allergies and chronic The disposal of videos, as exclusion
illnesses; breastfeeding as food economy, criteria, mostly occurred after a full analysis
complete nutrition for the infant and natural of their contents, after being watched, when
contraception for mothers; proper latching; we identified shootings associated to:
minimum time of Exclusive Breastfeeding advertisements for products related to
(EBF); information on labor rights during breastfeeding (educational and practical)
breastfeeding. presentations of children (corals, ballets)
With the aid of the developed tool, the during events on Breastfeeding (BF), breast
videos were watched, one by one, searching milk donation to milk banks, babies’ videos or
for direct references (verbal or non-verbal) of animals when suckling, stories about World
each one of the items contained thereof. Breastfeeding Week, campaigns of the
During the analysis of videos, it was noted Brazilian Ministry of Health - Ministério da
the frequent citation of some aspects Saúde (MS) to encourage the breastfeeding
considered relevant, but that were not and family support during the breastfeeding
present in such a tool. Then we decided to period, videos in other languages..
add these aspects to the tool, which led us to Other factors such as the repetition of
a new analysis of the videos that already had some of MS campaign videos and the poor
been watched. Despite the restart, it was quality of the productions (image and/or
considered relevant to the incorporation of audio) also resulted in the disposal of some of
new aspects, since it would be considerable them.
statistical data and could significantly Almost in their wholeness, the analyzed
contribute to the selection of videos. sample videos were stories (Table 1). The
The new aspects were: breastfeeding in the remaining videos were home-made
first hours of life, breastfeeding as an productions, MS or municipal campaigns on
important factor in reducing child mortality; the BF, health events performed by hospitals
breastfeeding as a mother’s protective factor or Family Health Programs (FHP) and
against cancer; and breastfeeding as an advertisements (DVDs on BF and products for
important factor for the physical and breastfeeding mothers).
psychosocial development of the child.
After being raised, the data were tabulated
and organized according to: date of
publication and its frequency in each month
and year; frequency of citation of each
question; frequency of citation of two
questions or less and three or over.
Table 1. Classification of the YouTube videos about
breastfeeding, analyzed in the year 2011.
Video Classification Totality of videos
Story 66
Home-made video 19
Campaign on BF 4
Health event 7
Advertisement 4

Table 2 shows the percentage of uploads of over the years, it should be noted a
videos on BF, firstly, according to the month progressive increase in the number of uploads.
and, next, over the years, from 2006 (oldest We have realized that, in 2011, this number is
record) to June 2011. It should be noted that, around one-half of the 2010 index, however,
during the year, the largest percentage of refers to a period of only 6 months, by
uploads are in ascending order in the months considering the deadline date of the survey:
of May and September. As for the comparison June 30th, 2011.

English/Portuguese
J Nurs UFPE on line., Recife, 7(spe):1016-22, Mar., 2013 1018
ISSN: 1981-8963 DOI: 10.5205/reuol.3934-31164-1-SM.0703esp201325

Carvalho JA de, Gurgel PKF, Lima KYN de et al. Análise de Vídeos do YOUTUBE sobre…

Of 175 videos, 54 make mention only about milk as a complete source of nutrients (28%);
one or two questions of the research tool. Of next, there are the act of breastfeeding as
this number, 61% show two questions. The formation of bonding between mother and
most discussed aspect was the minimum child and breast milk as a protective factor for
period of 6 months of EBF, cited by 44% of the the infant (both reached 20%).
videos, followed by the classification of breast
Table 2. Percentage of videos about breastfeeding, according to the month and
over the years, found on YouTube until June 2011.
Month % Uploads Month % Uploads Year % Uploads
Jan 3 Jul 6 2006 3
Feb 6 Aug 29 2007 2
Mar 3 Sep 9 2008 10
Apr 8 Oct 7 2009 27
May 11 Nov 9 2010 38
Jun 5 Dec 4 Jan-Jun 2011 20

Table 3 shows the data directly related to mentioned in 34% of videos. The other factors
the quality of the videos, now considering the have not reached one-half of the frequency of
totality of analyzed videos, regardless of the the most cited. The BF as natural
number of factors which are mentioned by contraception was cited in 4% of videos;
them. breast milk as food economy, in 16%; proper
Within the total of 175 videos considered latching as a decisive factor for the successful
suitable for this research, by observing the breastfeeding, in 18%; the existence of labor
frequency of approach of the factors listed in rights to ensure time for a working mother to
the research tool, it was realized that among breastfeed was mentioned in 6%; the
the most cited are: protection against importance of breastfeeding in the first hours
diseases and allergies (62%), EBF until six of life for a successful breastfeeding, in 18%;
months of age (61%), complete source of BF as a protective factor against breast
nutrients (57%) and building of the mother- cancer, in 25%; and BF as a way of reducing
child bond (55%). child mortality, in 14%.
Later, we observed that the breastfeeding
as a determinant factor for a good physical
and psychosocial development of the child is
Table 3. Frequencies of approach of the factors on breastfeeding found in YouTube videos
analyzed in 2011.
Cited factor %n Cited factor %n
Building of the mother-
55 Proper latching 18
child bond
Protection against diseases
62 Labor rights 6
and allergies
Food economy 16 Breastfeeding in the first hour of life 18
Complete source of
57 Protection against cancer 25
nutrients
Natural contraception 4 Reduction of child mortality 14
Satisfactory physical and psychosocial
EBF until six months of age 61 34
development
its YouTube channels. The several media have
DISCUSSION
bet on using the internet as a means of
An important point to be noted in this disseminating information. For them, this is a
analysis is related to the product advertising new form of writing, interacting,
videos. Despite not encourage breastfeeding, communicating and sharing, transmitting
none of them violates the Resolution 31/92 of images, videos and music, in order to reach
the National Health Council - Conselho new audiences, won by awakening the
Nacional de Saúde (CNS/MS), which brings interest of new sources of online information.6
veto to the incitement to sale, regardless of It is possible to realize that over the years,
means or form, of artificial foods for replacing from 2006 to June 2011, there was a
the breast milk, in an indiscriminate way and, considerable increase in uploading videos
mainly, for children in the first six months of about BF on YouTube. This may have resulted
life.5 from greater access to the internet, as well as
The majority of videos in the form of because of the campaigns to encourage
stories indicate suitability of the information, breastfeeding, which are held by the MS. In
since it is believed that they are performed by recent decades, promotional and protective
professionals committed to the truthfulness of actions have been put into practice to support
the content of their stories. Many of the the breastfeeding act, in order to reduce child
videos were uploads of the TV media itself in mortality and improve the children’s health.
English/Portuguese
J Nurs UFPE on line., Recife, 7(spe):1016-22, Mar., 2013 1019
ISSN: 1981-8963 DOI: 10.5205/reuol.3934-31164-1-SM.0703esp201325

Carvalho JA de, Gurgel PKF, Lima KYN de et al. Análise de Vídeos do YOUTUBE sobre…

We already can observe improvements in consequences and supporting in the successful


breastfeeding indexes, but some erroneous breastfeeding.12
practices still make the prevalence of EBF Among the four most cited factors, breast
remains far from the desirable goal.7 milk is crucial for the physical and
The major difficulties faced for beginning psychosocial development of the child, with a
and maintaining the breastfeeding are related considerable share of citation of 34%,
to disinformation population about the followed by the breastfeeding factor as
importance of such a healthy habit, as well as maternal protection against some cancers,
the risks of artificial milks and early mixed such as breast cancer, with 25 %. It is
diet. Besides these ones, there are still important to make the mother becomes aware
misinformation about labor rights of the of the benefit that the breastfeeding also
mother; about how to conduct the proper brings to her, so that she will feel more
latching, which often hinders and even encouraged to breastfeed. Studies performed
prevents breastfeeding; and the minimum EBF in developed and undeveloped countries
time that the child needs.8 showed that the longer the duration of
Approximately 1/3 of the analyzed videos breastfeeding, the woman acquires increased
mention only two factors that are considered protection against breast cancer.11
important. Comparing them with others, Four of the remaining items analyzed were
which mention from three to nine factors, we maintained with an average of 16.5% of
have noted that, in general, the most cited citation among videos. Among them, there are
are the same for both groups of videos and are the proper latching and stimulation of
also those ones addressed in the surveyed breastfeeding within the first hour of life.
studies, namely: building of the mother-child Successful breastfeeding directly depends on
bond, protection against diseases and these two factors. An improper latching can
allergies, complete source of nutrients and cause nipple injuries and prevent the
EBF in the first six months of age. continuity of breastfeeding. 13 As for suckling
In the works on the issue at stake, the main in the first hour of life, it is crucial to the
speech is directed to the four aforementioned maintenance of breastfeeding. Studies have
factors. The BF is seen as a single source of shown that weaning was reduced among
nutrition and enough for the infant, which women who breastfed in the first six hours of
also brings the protective function and is the newborns life and reinforce the
essential for a good physical and psychosocial importance of early rapprochement between
developing, due to the establishing of the mother and child with a view of forming bond,
strong bond between mother and child.9 as well as helping in the milk ejection reflex.14
Breast milk is produced according to the The knowledge of labor rights of the
needs of each infant. Not only that, but due mother did not prove to be determining factor
to its perfect composition, it is impossible to for breastfeeding, since it is mentioned a few
be reproduced. Acts as a source of food and times, in about 6% of the surveyed videos.
medication at the same time, by being able to Nonetheless, the working mother should be
immediately act and prevent several diseases clarified about them so they do not become
of childhood and adulthood, as well as an obstacle to the breastfeeding. Having
providing all the fuel necessary for the science on the maternity leave, as well as the
physical, intellectual and emotional right to breastfeed in her workplace are
10
development of the newborn. But, for that relevant factors for awareness of this
to take effect, the World Health Organization mother.15
(WHO) recommends that the infant feed itself With low incidence, the breastfeeding
only through milk during the first six months factor as a natural contraceptive method is
of life, a phase in which there is the largest also cited (4% of the analyzed videos). In spite
child development, without the provision of of being a benefit to the mother, this
any other supplementary food or drink.11 procedure is not totally safe to be singly used,
Regardless of the number of factors because it is related to the length of
mentioned in each video, it should be noted breastfeeding, which should be exclusive or
that there is a greater concern in relation to almost exclusive, and either to the maternal
reflect the importance of the EBF in the first physiology of menstruation return.16
six months of a child's life, especially in the
FINAL REMARKS
first hour of life. This is really the most
important factor, since the setting up of the The study showed that the analyzed videos
awareness of mothers regarding the minimum do not show negatives points in encouraging
time for EBF, all other also relevant aspects breastfeeding and, despite all of them do not
will be accepted and may work as address the factors listed in the research tool
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J Nurs UFPE on line., Recife, 7(spe):1016-22, Mar., 2013 1020
ISSN: 1981-8963 DOI: 10.5205/reuol.3934-31164-1-SM.0703esp201325

Carvalho JA de, Gurgel PKF, Lima KYN de et al. Análise de Vídeos do YOUTUBE sobre…

in its entirety, there is a focus on the most http://www.revistas.univerciencia.org/index.


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ISSN: 1981-8963 DOI: 10.5205/reuol.3934-31164-1-SM.0703esp201325

Carvalho JA de, Gurgel PKF, Lima KYN de et al. Análise de Vídeos do YOUTUBE sobre…

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Submission: 2012/09/03
Accepted: 2013/01/19
Published: 2013/03/2013
Corresponding Address
Francis Solange Vieira Tourinho
Departamento de Enfermagem
Universidade Federal do Rio Grande do Norte
English/Portuguese
J Nurs UFPE on line., Recife, 7(spe):1016-22, Mar., 2013 1022

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